Complications and associated risk factors of open reduction and internal fixation among adult patients with tibial plateau fractures

Background: Tibial plateau fractures are complex injuries that often require open reduction and internal fixation (ORIF) for optimal recovery. However, complications and risk factors associated with ORIF can significantly impact patient outcomes. This study aimed to evaluate the complications and associated risk factors of open reduction and internal fixation and their effect on functional recovery in adult patients with tibial plateau fractures. Methods: This prospective observational study was conducted in the Department of Orthopaedics and Traumatology, Chittagong Medical College Hospital, Chattogram, Bangladesh, from January 2018 to December 2019. This study included 50 adult patients of both genders with high-energy tibial plateau fractures through a consecutive sampling technique. Functional outcomes were assessed over six months and statistical associations with risk factors were examined. Results: The mean age of patients was 43.95±10.89 years, with a male predominance (76%). The most common fracture type was Type VI (72%) and the majority were closed fractures (84%). The average time from injury to surgery was 11.05±3.203 days, with a mean operative duration of 107±12.074 minutes. At six months, 82% of patients achieved excellent functional outcomes, while 10% had good and 4% each had moderate and poor outcomes. The mean fracture union time was 15.39±1.614 weeks. Infection significantly affected recovery (p=0.008), with 92.7% of infection-free patients achieving excellent results, whereas 33.3% of those with superficial infections had moderate outcomes and all patients with deep infections had poor outcomes. Gender also had a significant impact (p=0.047), with 80.4% of males achieving excellent outcomes compared to 19.5% of females. Conclusions: The findings show that ORIF in tibial plateau fractures generally results in favorable outcomes, but factors like gender and post-operative infections significantly influence recovery. Effective infection control and individualized patient management may enhance surgical success and functional outcomes.